title: The relationship between primary prescription opioid and buprenorphine-naloxone induction outcomes in a prescription opioid dependent sample.
abstract: OBJECTIVE
  This analysis aims to: (1) compare induction experiences among participants who self-reported using one of the four most commonly reported POs, and (2) examine factors associated with difficult bup-nx induction. Our hypothesis, based on previous research and current guidelines, is that those on longer-acting opioids will have experienced more difficult inductions.
  
  
  METHODS
  The Prescription Opioid Addiction Treatment Study (POATS) was a multi-site, randomized clinical trial, using a two-phase adaptive treatment research design. This analysis examines bup-nx induction of participants who self-reported primary PO use of methadone, ER-oxycodone, IR-oxycodone, and hydrocodone (n = 69). Analyses examined characteristics associated with difficult induction, defined as increased withdrawal symptoms measured by the Clinical Opiate Withdrawal Scale (COWS) after the first bup-nx dose with higher scores denoting greater withdrawal symptoms/severity.
  
  
  RESULTS
  Contrary to our hypothesis, difficult induction experiences did not differ by primary PO type. Those who experienced a post-induction increase in COWS score had lower pre-dose COWS scores compared to those who did not experience a post-induction increase in COWS score (10.09 vs. 12.77, t(624) = -13.56, p < .001). Demographics characteristics, depression, and pain history did not predict a difficult induction.
  
  
  CONCLUSIONS
  Difficult bup-nx inductions were not associated with participants' primary PO. Severity of withdrawal, measured with the COWS, was an important variable, reminding clinicians that bup-nx should not be commenced prior to evidence of moderate opioid withdrawal. These findings add to the evidence that with careful procedures, bup-nx can used with few difficulties in PO-dependent patients. (Am J Addict 2014;23:343-348).
authors.affiliation: UCLA Integrated Substance Abuse Programs, Los Angeles, California; University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Nielsen
authors.forename: Maureen
authors.initials: M
authors.lastname: Hillhouse
authors.forename: Roger D
authors.initials: RD
authors.lastname: Weiss
authors.forename: Larissa
authors.initials: L
authors.lastname: Mooney
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sharpe Potter
authors.forename: Joshua
authors.initials: J
authors.lastname: Lee
authors.forename: Marc N
authors.initials: MN
authors.lastname: Gourevitch
authors.forename: Walter
authors.initials: W
authors.lastname: Ling
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D002047:Buprenorphine / Q000627:therapeutic use*; D003692:Delayed-Action Preparations / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D055553:Prescription Drugs / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations; D009292:Narcotic Antagonists; D055553:Prescription Drugs; D009270:Naloxone; D002047:Buprenorphine
keywords: buprenorphine; induction; prescription opioid dependence